A scoping review to identify and describe the characteristics of theories, models and frameworks of health research partnerships

Frameworks Used to Engage Postsecondary Students in Campus Mental Health Research: A Scoping Review

BACKGROUND

There is an increasing prevalence of mental health concerns reported among postsecondary students (PSS) and growing demands for care on campuses around the world, as such there is an urgent need for research and innovations in PSS mental health that engages PSS. However, best practices and guidelines for facilitating PSS engagement in research is lacking. To address this gap, we undertook this review to explore frameworks used for engaging with PSS in research focused on PSS mental health.

METHODS

A scoping review of the academic literature was conducted. Frameworks used to engage PSS in mental health research were identified and categorized using the taxonomy of patient and public engagement by Greenhalgh et al. A list of barriers and facilitators to engaging with PSS was also identified and reported.

RESULTS

Of the articles assessed for full-text screening (n = 167), 26 journal articles were included. Frameworks used for engaging PSS in mental health research were classified into one of the three categories from Greenhalgh et al.'s taxonomy: study-focused (n = 14), partnership-focused (n = 9) and power-focused (n = 3). No relevant frameworks were found for two categories: priority- and report-focused. Seven documents reported relational or process-related barriers and/or facilitators to engaging with PSS. Based on these findings, recommendations were drafted with PSS advisors on how to implement an engagement framework in PSS mental health research.

CONCLUSIONS

We identified existing practices outlined within frameworks used to engage PSS and barriers and facilitators to engage with PSS in mental health research. Based on the review findings and PSS advisors recommendations, a need for developing a comprehensive engagement framework specific to the PSS context was identified.

PATIENT OR PUBLIC CONTRIBUTION

The research team led consultations with a PSS advisory group for this review. Student advisors were actively engaged in data analysis, which included categorizing and drafting of recommendations, and the preparation of this manuscript.

A scoping review on the current state of sex- and gender-based analysis (SGBA) in standing balance research

BACKGROUND

Understanding sex and gender differences in standing balance is challenged by varied use of terminology and definitions. In addition, the use of sex- and gender-based analyses (SGBA) in standing balance research is unknown. This scoping review examined the frequency and type of SGBA, and the use of sex- and gender-based terminology in standing balance research published in the year 2020.

METHODS

Eight databases were searched for peer-reviewed articles that quantitatively measured standing balance in adult humans using a biomechanical construct and were published in 2020. Two independent reviewers screened abstracts and extracted data with a third reviewer resolving conflicts. In accordance with sex and gender equity in research (SAGER) guidelines, data extraction focused on participant demographics, inclusion and type of SGBA, consistency of sex and gender terminology, alignment with operational definitions (e.g., female used to describe sex), and sex and gender data collection methods. Absolute and relative values across all articles and within collaboratively created categories of participant groups were calculated.

RESULTS

Of the 366 articles in the analysis, 20 % included sex and/or gender in the statistical analyses of which 50 % conducted SGBA. Consistent terminology aligned with this study's definitions of sex and gender was found in 12 % of all articles, whereas 40 % used labels consistently without assigning them to sex or gender, ∼20 % used inconsistent or unaligned terminology, and 7 % did not report sex or gender. No articles included more than two options for sex or gender, and very few included self-reporting by participants (3 % for sex, 1 % for gender) or clearly described how sex (3 %) or gender (1 %) data were collected.

CONCLUSIONS

Small changes to the collection and reporting of sex and gender, and more SGBA in standing balance research could drastically improve the inclusivity and accuracy of standing balance assessment in research and clinical settings.

Partnered health research in Canada: a cross-sectional survey of perceptions among researchers and knowledge users involved in funded projects between 2011 and 2019

BACKGROUND

Engaging knowledge users in health research is accelerating in Canada. Our objective was to examine perceptions of partnered health research among individuals involved in funded Canadian partnered health research projects between 2011 and 2019.

METHODS

We invited 2155 recipients of 1153 funded projects to answer a questionnaire probing project characteristics and perceptions of partnered health research. We described and compared perceived effects of involving knowledge users in the project, team cohesion, capability, opportunity and motivation for working in partnership between two categories of respondents: project role [nominated principal investigators (NPIs), other researchers and knowledge users] and gender.

FINDINGS

We analysed data from 589 respondents (42% NPIs, 40% other researchers and 18% knowledge users; 56% women). Among the perceived effects variables, the proportion of ratings of significant influence of involving knowledge users in the project ranged between 12% and 63%. Cohesion, capability, opportunity and motivation variables ranged between 58% and 97% agreement. There were no significant differences between respondent groups for most variables. NPIs and women rated the overall influence of involving knowledge users as significant more than other respondent groups (p < 0.001). NPIs also reported higher agreement with feeling sufficiently included in team activities, pressure to engage and partnerships enabling personal goals (all p < 0.001).

CONCLUSIONS

Most respondents held positive perceptions of working in partnership, although ratings of perceived effects indicated limited effects of involving knowledge users in specific research components and on project outcomes. Continued analysis of project outcomes may identify specific contexts and partnership characteristics associated with greater impact.

Outcomes of an integrated knowledge translation approach in five African countries: a mixed-methods comparative case study

BACKGROUND

Integrated knowledge translation (IKT) aims to enhance evidence-informed decision-making in public health and healthcare by establishing continuous relationships between researchers and knowledge users, in particular decision-makers. The Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) undertook research on noncommunicable diseases in Ethiopia, Malawi, Rwanda, South Africa and Uganda. Alongside the research activities, we implemented an IKT approach, which entailed training and the development and implementation of site-specific IKT strategies. We evaluated these strategies according to a predefined programme theory.

METHODS

Drawing on our published protocol ( https://rdcu.be/dyfBP ), we interviewed and surveyed CEBHA+ researchers and their decision-making counterparts during two project stages (3/2020-2/2021; 9/2022-5/2023) and collected IKT-related documents. Transcripts and documents were analysed using qualitative content analysis and surveys were analysed descriptively, with subsequent integration, cross-case analysis and revision of the programme theory.

RESULTS

A total of 36 researchers and 19 decision-makers participated in surveys, focus groups and/or interviews, and we collected 92 documents. Relationship building, capacity building and collaborative research were the most proximal intervention outcomes: CEBHA+ researchers and their counterparts built mutual appreciation and partnerships, accessed contacts and networks, and expanded skills in conducting and using research and in IKT. The level of trust between partners varied. Intermediate outcomes were changes in attitudes and knowledge; beyond the conceptualization in our initial programme theory, researchers substantially increased their understanding of the decision-making context and developed a vision for "research impact". While it was challenging to evaluate distal outcomes, the IKT approach was linked to the production of research perceived as addressing local priorities and being highly applicable and contextualized, and some consideration of evidence among decision-makers. Unintended effects included high opportunity costs associated with undertaking IKT. An unanticipated outcome was the heightened interest of the research funder in policy engagement. Our updated programme theory constitutes a low-level theory for IKT.

CONCLUSIONS

Whilst this study faced many challenges common to the evaluation of knowledge translation interventions, it presents rich, theory-informed insights into IKT outcomes. These are based on documented IKT activities and participants' views, particularly in-depth insights of researchers' experiences with implementing the CEBHA+ IKT approach.

Community-engaged research: Bringing the science of developmental psychopathology into the real world

The science of developmental psychopathology has made outstanding progress over the past 40 years in understanding adaptive and maladaptive developmental processes across the life span. Yet most of this work has been researcher driven with little involvement of community partners in the research process, limiting the potential public health significance of our work. To continue to advance the field we must move beyond the physical and conceptual walls of our research laboratories and into the real world. In this article, we define and describe the importance of community-engaged research, and present our overarching principles for engaging the community including practicing respect, shared power and decision-making, prioritizing the needs of the community, and engaging in consistent and transparent communication. We present several associated recommendations for best practice and highlight examples from our own research that is grounded in a developmental psychopathology perspective to illustrate these practices. Recommendations for the future of the discipline of development and psychopathology, with emphasis on training and continuing education, are described.

Improving Diverse and Equitable Involvement of Patients and Caregivers in Research in CKD: Report of a Better Evidence and Translation-Chronic Kidney Disease (BEAT-CKD) Workshop

Patient and caregiver involvement can enhance the uptake and impact of research, but the involvement of patients and caregivers who are underserved and marginalized is often limited. A better understanding of how to make involvement in research more broadly accessible, supportive, and inclusive for patients with chronic kidney disease (CKD) and caregivers is needed. We conducted a national workshop involving patients, caregivers, clinicians, and researchers from across Australia to identify strategies to increase the diversity of patients and caregivers involved in CKD research. Six themes were identified. Building trust and a sense of safety was considered pivotal to establishing meaningful relationships to support knowledge exchange. Establishing community and connectedness was expected to generate a sense of belonging to motivate involvement. Balancing stakeholder goals, expectations, and responsibilities involved demonstrating commitment and transparency by researchers. Providing adequate resources and support included strategies to minimize the burden of involvement for patients and caregivers. Making research accessible and relatable was about nurturing patient and caregiver interest by appealing to intrinsic motivators. Adapting to patient and caregiver needs and preferences required tailoring the approach for individuals and the target community. Strategies and actions to support these themes may support more diverse and equitable involvement of patients and caregivers in research in CKD.

The effectiveness of knowledge-sharing techniques and approaches in research funded by the National Institute for Health and Care Research (NIHR): a systematic review

BACKGROUND

The National Institute of Health and Care Research (NIHR), funds, enables and delivers world-leading health and social care research to improve people's health and wellbeing. To achieve this aim, effective knowledge sharing (two-way knowledge sharing between researchers and stakeholders to create new knowledge and enable change in policy and practice) is needed. To date, it is not known which knowledge sharing techniques and approaches are used or how effective these are in creating new knowledge that can lead to changes in policy and practice in NIHR funded studies.

METHODS

In this restricted systematic review, electronic databases [MEDLINE, The Health Management Information Consortium (including the Department of Health's Library and Information Services and King's Fund Information and Library Services)] were searched for published NIHR funded studies that described knowledge sharing between researchers and other stakeholders. One researcher performed title and abstract, full paper screening and quality assessment (Critical Appraisal Skills Programme qualitative checklist) with a 20% sample independently screened by a second reviewer. A narrative synthesis was adopted.

RESULTS

In total 9897 records were identified. After screening, 17 studies were included. Five explicit forms of knowledge sharing studies were identified: embedded models, knowledge brokering, stakeholder engagement and involvement of non-researchers in the research or service design process and organisational collaborative partnerships between universities and healthcare organisations. Collectively, the techniques and approaches included five types of stakeholders and worked with them at all stages of the research cycle, except the stage of formation of the research design and preparation of funding application. Seven studies (using four of the approaches) gave examples of new knowledge creation, but only one study (using an embedded model approach) gave an example of a resulting change in practice. The use of a theory, model or framework to explain the knowledge sharing process was identified in six studies.

CONCLUSIONS

Five knowledge sharing techniques and approaches were reported in the included NIHR funded studies, and seven studies identified the creation of new knowledge. However, there was little investigation of the effectiveness of these approaches in influencing change in practice or policy.

Accelerating knowledge translation to improve cardiovascular outcomes and health services: opportunities for bridging science and clinical practice

Knowledge translation (KT) is the exchange between knowledge producers and users to understand, synthesize, share, and apply evidence to accelerate the benefits of research to improve health and health systems. Knowledge translation practice (activities/strategies to move evidence into practice) and KT science (study of the methodology and approaches to promote the uptake of research) benefit from the use of conceptual thinking, the meaningful inclusion of patients, and the application of intersectionality. In spite of multiple barriers, there are opportunities to develop strong partnerships and evidence to drive an impactful research agenda and increase the uptake of cardiovascular research.

Partnering with patients and caregivers to enrich research and care in kidney disease: values and strategies

Patient and caregiver involvement broadens the scope of new knowledge generated from research and can enhance the relevance, quality and impact of research on clinical practice and health outcomes. Incorporating the perspectives of people with lived experience of chronic kidney disease (CKD) affords new insights into the design of interventions, study methodology, data analysis and implementation and has value for patients, healthcare professionals and researchers alike. However, patient involvement in CKD research has been limited and data on which to inform best practice is scarce. A number of frameworks have been developed for involving patients and caregivers in research in CKD and in health research more broadly. These frameworks provide an overall conceptual structure to guide the planning and implementation of research partnerships and describe values that are essential and strategies considered best practice when working with diverse stakeholder groups. This article aims to provide a summary of the strategies most widely used to support multistakeholder partnerships, the different ways patients and caregivers can be involved in research and the methods used to amalgamate diverse and at times conflicting points of view.

User-centered design of feedback regarding health-related behaviors derived from wearables: An approach targeting older adults and persons living with neurodegenerative disease

Objective

There has been tremendous growth in wearable technologies for health monitoring but limited efforts to optimize methods for sharing wearables-derived information with older adults and clinical cohorts. This study aimed to co-develop, design and evaluate a personalized approach for information-sharing regarding daily health-related behaviors captured with wearables.

Methods

A participatory research approach was adopted with: (a) iterative stakeholder, and evidence-led development of feedback reporting; and (b) evaluation in a sample of older adults (n  =  15) and persons living with neurodegenerative disease (NDD) (n  =  25). Stakeholders included persons with lived experience, healthcare providers, health charity representatives and individuals involved in aging/NDD research. Feedback report information was custom-derived from two limb-mounted inertial measurement units and a mobile electrocardiography device worn by participants for 7-10 days. Mixed methods were used to evaluate reporting 2 weeks following delivery. Data were summarized using descriptive statistics for the group and stratified by cohort and cognitive status.

Results

Participants (n  =  40) were 60% female (median 72 (60-87) years). A total of 82.5% found the report easy to read or understand, 80% reported the right amount of information was shared, 90% found the information helpful, 92% shared the information with a family member or friend and 57.5% made a behavior change. Differences emerged in sub-group comparisons. A range of participant profiles existed in terms of interest, uptake and utility.

Conclusions

The reporting approach was generally well-received with perceived value that translated into enhanced self-awareness and self-management of daily health-related behaviors. Future work should examine potential for scale, and the capacity for wearables-derived feedback to influence longer-term behavior change.